Clofar - Pharmacology:

Clofar increases the activity of extrahepatic lipoprotein lipase (LL), thereby increasing lipoprotein triglyceride lipolysis. Chylomicrons are degraded, VLDLs are converted to LDLs, and LDLs are converted to HDL. This is accompanied by a slight increase in secretion of lipids into the bile and ultimately the intestine. Clofar also inhibits the synthesis and increases the clearance of apolipoprotein B, a carrier molecule for VLDL.

Clofar Interactions

Caution should be exercised when anticoagulants are given in conjunction with Atromid-S. Usually, the dosage of
the anticoagulant should be reduced by one-half (depending on the individual case) to maintain the prothrombin time
at the desired level to prevent bleeding complications. Frequent prothrombin determinations are advisable until it
has been determined definitely that the prothrombin level has been stabilized.

Atromid-S may displace acidic drugs such as phenytoin or tolbutamide from their binding sites. Caution should be
exercised when treating patients with either of these drugs or other highly protein-bound drugs and Atromid-S. The
hypoglycemic effect of tolbutamide has been reported to increase when Atromid-S is given concurrently.

Fulminant rhabdomyolysis has been seen as early as three weeks after initiation of combined therapy with another
fibrate and lovastatin but may be seen after several months. For these reasons, it is felt that, in most subjects who
have had an unsatisfactory lipid response to either drug alone, the possible benefits of combined therapy with
lovastatin and a fibrate do not outweigh the risks of severe myopathy, rhabdomyolysis, and acute renal failure. While
it is not known whether this interaction occurs with fibrates other than gemfibrozil, myopathy and rhabdomyolysis
have occasionally been associated with the use of fibrates alone, including clofibrate. Therefore, the combined use
of lovastatin with fibrates should generally be avoided.

Clofar Contraindications

Clofar is contraindicated in pregnant women. While teratogenic studies have not demonstrated any effect
attributable to clofibrate, it is known that serum of the rabbit fetus accumulates a higher concentration of
clofibrate than that found in maternal serum, and it is possible that the fetus may not have developed the enzyme
system required for the excretion of clofibrate.

It is contraindicated in patients with clinically significant hepatic or renal dysfunction. Rhabdomyolysis and
severe hyperkalemia have been reported in association with pre-existing renal insufficiency.

It is contraindicated in patients with primary biliary cirrhosis, since it may raise the already elevated
cholesterol in these cases.

It is contraindicated in patients with a known hypersensitivity to clofibrate.